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The waiting game

This Budget will deepen the crisis in general practice

Dr Kailash Chand

Chancellor Philip Hammond’s Budget statement was a massive let down for the NHS in general and general practice in particular. The NHS is facing one of the most challenging periods in its history and the announcement has fallen well short of what is needed to address the long-term funding problems, which unfortunately look set to continue.

This Budget does nothing to address the gaping hole in NHS finances. There is a £30 bn gap to fill and we should be increasing the UK’s health spending by at least £10.3 bn to match that of other leading European economies. The most worrying aspect of delivering the lowest additional funding increase to the NHS in the budget means a knock-on effect on patients, in terms of treatment and facilities available.

Increasing pressure on services means that many waiting time targets haven’t been met for years and patients face longer delays to see their GP as the crisis in general practice has left many surgeries struggling to cope.

As government figures published this week reveal a significant fall in the number of GPs and that three in four medical specialities are struggling to fill training places, recruitment and retention should be a priority for the NHS – yet the budget offers little solution to this crisis.

The Chancellor’s failure to commit to extra funding for public health issues means that the damaging impact of alcohol, tobacco and poor diet will continue to cost the NHS billions each to year to treat.

But, most importantly, this Budget has once again ignored the needs of general practice and is further pushing it into a permanent decline. My feelings lay somewhere between anger and disappointment.

Disappointment that Mr Hammond doesn’t realise that if general practice fails, the whole NHS fails.

Angry that nobody seems to understand the seriousness of the situation facing general practice in England.

General practice’s share of the NHS udget has fallen progressively in the past decade, from a high of 11% in 2006 to less than 8.5% now. Many practices will see further reductions over the next three years, forcing further closures. A combined financial and staffing crisis could cause chaos in primary care for years and ultimately kill off general practice for good.

Our health system is under pressure like never before. General practice in the NHS has been very shabbily treated by the Department of Health and Treasury in recent years and it is now very much a fading jewel. The future for GPs, their teams and their patients looks very uncertain as a result of this Budget. It is hard to see how current levels of funding can sustain a readily accessible, high-quality service. The moment of crisis many warned of has arrived, and this budget will only sink it into further turmoil.

Dr Kailash Chand is a retired GP from Tameside and is honorary vice-president of the BMA


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Readers' comments (5)

  • The obvious answer to raising more money for the NHS is to do what the rest of the developed world does - insurance or co-payments from the users - and stop expecting the State to pay for everything.

    But Chand and the BMA long ago lost the plot.

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  • Dear Stelio - once you have insurance and co-pay, you will instantly create a two tier health care system - we have enough social inequality as it is. Proper taxation and a clamp down on tax evasion strategies by the super rich and corporates would easily close the gap. One simple suggestion- ground rents in the UK - most go to off shore companies paying no tax on £250-300 per household. 40% of this £100-120 per house/apartment - do the maths. Why is BMA and RCGP not getting onto this? We can fund a decent NHS.... we just need to nail down those who shirk their social responsibilities.

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  • Rubbish! Asking the middle class to contribute something at point of delivery for basic medical services will not create a two tear system. Germany, France and New Zealand all manage this. We have to abandon this mind-set - it is literally killing UK patients. The tax-pay should share the risk of the big things like cancer surgery and so forth so we don't end up bankrupting ourselves like the Americans. If you want to reduce social inequality, cutting general practice to the extent that surgeries in poor areas are closed is not the way to go about it. Instead invest in jobs and schools. Yes, the delinquent rich should stop getting Vat off private jets but this requires tax reform and probably international co-operation at a time when the UK has just decided it wants to run as a tax haven.

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  • That the BMA repeatedly sacrifices the interests of it's members for the alleged needs of the NHS is a significant contributor to our current problems.

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  • Don't worry.....once Brexit happens the NHS can look forward to any extra £350 million per week.......that's right isn't it?

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